Credentialing

Physician and Advanced Practice Provider (APP) Credentialing

Credentialing is an important step for any physician or advanced practice provider who is new to Kids Health First. The credentialing packet is lengthy and requires accurate information as required by Kids Health First and the insurance companies. Once complete packets are received, credentialing by Kids Health First takes approximately 45-60 days for a new provider. It generally takes an additional 30-90 days for a payor to input the new provider into their systems.

Please follow all directions noted on each of the applicable forms (click below to access these forms). Missing information or missing supporting documents can delay the process. Please retain a copy of all completed documents for your records.

For practices that accept Medicaid, please complete the Georgia Medicaid application for your new provider as soon as possible. It can take up to 6 months for a provider obtain a Georgia Medicaid ID. Medicaid payor(s) will not accept data for a new provider until we can provide an active, location-specific Medicaid ID. Enrollment instructions and documents for the Department of Community Health’s (DCH) Credentialing Verification Organization (CVO) can be found at the GAMMIS website.

 

Approval letters are sent to practices ~2 weeks after credentialing meeting.

Payor files submitted once a month:

  • Aetna, Humana, Multiplan, United Health Care - End of each month
  • Peach State - 15th of each month

Reminder: Cigna is not delegated. KHF sends provider data on practices behalf to initiate credentialing. 

  • Cigna will have a unique effective date. 

Credentialing Committee 2025 Meeting Schedule

 

Month

Last Day

to Submit Documents

Credentialing

Meeting Date

January

1/7/2025

1/14/2025

February

2/4/2025

2/11/2025

March

3/4/2025

3/11/2025

April

4/1/2025

4/8/2025

May

5/6/2025

5/13/2025

June

6/3/2025

6/10/2025

July

7/1/2025

7/8/2025

August

8/5/2025

8/12/2025

September

9/2/2025

9/9/2025

October

10/7/2025

10/14/2025

November

11/4/2025

11/11/2025

December

12/2/2025

12/9/2025

Approval letters are sent to practices ~2 weeks after credentialing meeting.

Payor files submitted once a month:

  • Aetna, Humana, Multiplan, United Healthcare – End of each month
  • Peach State – 15th of each month

Reminder: Cigna is not delegated. KHF sends provider data on practices’ behalf to initiate credentialing. 

  • Cigna will have a unique effective date.

For more provider credentialing information or questions, please contact us at credentialing@khfirst.com or contact Kathryn Glass at KGlass@khfirst.com or call 770-333-0033, ext. 203.

Please retain a copy of all completed documents for your records.